Digoxin (Lanoxin) is a medication used to treat congestive heart failure. In order to monitor the effectiveness of digoxin and prevent adverse effects, nurses must understand the health history, physical examination, diagnostic tests, nursing care plan and nursing interventions for this drug.
Nursing Consideration For Digoxin
1 Health History and Physical Examination
The health history is the patient’s past medical history. It includes any previous illnesses, injuries or surgeries. This information is crucial because it allows you to make accurate assessments about current conditions, including what has been done in the past and how effective those actions were. A good example of this might be a patient who had previous surgery for a tumor in their lung but now complains of shortness of breath after exercise. You would want to know about this so that you can assess if there are any complications from the surgery itself or perhaps something else going on like pneumonia or anemia (which could cause fatigue).* Family History
The family history involves information that goes back through generations: grandparents, parents and siblings — even great-grandparents if possible.* Social History/Past Illnesses/Past SurgeriesThis section relates closely with “Health History”. It covers everything from weight loss due to surgery; contagious illness such as flu or chickenpox; recent diet changes that may affect your nutritional status; stress levels (including traumatic life events like divorce etc.).
The first step in determining the appropriate DIG toxicity management is assessment for signs of DIG toxicity. Assess for the following:
- Hypotension and/or bradycardia, especially if it is refractory to fluid resuscitation
- Heart block that progresses from 2nd degree AV block to complete heart block or junctional rhythm with an escape pacemaker (if not already present)
- Complete AV conduction failure, requiring temporary pacing
- Pulmonary edema or congestive heart failure associated with acute renal impairment (acute tubular necrosis), central nervous system depression, seizures, hypokalemia (prolonged QT interval on ECG), and/or respiratory paralysis due to neuromuscular blockade
3 Diagnostic Test
- Diagnostic tests that could be used to monitor digoxin
- How to use diagnostic tests to monitor digoxin
- What to do if the diagnostic test results are abnormal
- How to interpret the diagnostic test results
4 Laboratory Values
- Low serum potassium
- Elevated liver enzymes (AST, ALT, alkaline phosphatase, GGT)
- Decreased platelet count or prolonged prothrombin time.
Digoxin is a cardiac glycoside used to treat heart failure, atrial fibrillation, and ventricular tachycardia. It may also be used to reduce the symptoms of angina pectoris (chest pain). The drug is available in tablet form and can be taken orally or by injection.
Side effects of digoxin include hypotension, heart blockage (complete AV block), nausea, vomiting, anorexia (loss of appetite) and renal calculi formation. Nursing considerations include monitoring pulse rate every four hours; administering fluids if patient complains of thirst; checking stool consistency daily; monitoring serum potassium levels periodically; notifying physician if any signs/symptoms develop such as skin rash/hives/itching/swelling around eyes/mouths or wheezing during administration
6 Nursing Care Plan
The nurse will closely monitor the patient’s heart rate and blood pressure. The medication is frequently used to treat patients with digitalis toxicity, and nurses must be able to recognize signs of this toxicity.
The nurse should also note any changes in the patient’s symptoms or condition since they began taking digoxin.
7 Nursing Interventions and Rationales
Nursing Interventions and Rationale
- Monitor your patient’s heart rate and blood pressure. If either of these values changes dramatically, take action immediately.
- Monitor for signs of toxicity (i.e., nausea, vomiting). If present, administer antiemetics as needed to relieve symptoms and prevent dehydration.
- Monitor for signs of hypo- or hyperkalemia (i.e., fatigue, muscle weakness). Administer potassium supplements if indicated based on lab results; monitor potassium levels closely thereafter to ensure they remain within normal range as directed by physician orders or protocol standards for your facility/setting.* If you experience difficulty administering IV push medications through an infusion pump due to a possible malfunctioning system or an obstruction in the line, contact nursing staff immediately so that they can assist with troubleshooting processes until it’s resolved.* Monitor patients who receive digoxin regularly at close intervals during hospitalization due to increased risk of complications if dosages are not adjusted correctly following discharge from ICU unit care settings.* Ensure vital signs remain within normal limits according to protocol standards before administering medications such as digoxin; consider asking other nurses who may be administering these types of drugs also using infusion pumps whether their infusion systems work properly before giving them access; inform physicians immediately if there is any type issue preventing proper delivery dosage levels being delivered into patient veins through IV lines once installed onto catheters in order for them
8 The next time you’re with a patient who’s having this drug, remember that you need to monitor the patient’s heart rate and BP.
Remember that you need to monitor the patient’s heart rate and BP. You also need to be aware of any arrhythmias, such as bradycardia or tachycardia. Additionally, monitor for signs of electrolyte imbalances (hypokalemia or hyperkalemia) and digoxin toxicity in addition to observing for signs of hyponatremia.
The next time you’re with a patient who’s having this drug, remember that you need to monitor the patient’s heart rate and BP. To summarize the nursing considerations for digoxin: